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Antell
If you're considering facelift
plastic surgery...
As people age, the effects of gravity, exposure
to the sun, and the stresses of daily life can be
seen in their faces. Deep creases form between the
nose and mouth; the jawline grows slack and jowly;
folds and fat deposits appear around the neck.
A facelift (technically known as rhytidectomy)
can't stop this aging process. What it can do is
"set back the clock," improving the most visible
signs of aging by removing excess fat, tightening
underlying muscles, and redraping the skin of your
face and neck. A facelift can be done alone, or
in conjunction with other procedures such as a forehead
lift, eyelid surgery, or nose reshaping.
If you're considering a facelift, this will give
you a basic understanding of the procedure when
it can help, how it's performed, and what results
you can expect. It can't answer all of your questions,
since a lot depends on the individual patient and
the surgeon. Please ask your surgeon about anything
you don't understand.
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The best candidates for
facelifts
The best candidate for a facelift is a man or
woman whose face and neck have begun to sag, but
whose skin still has some elasticity and whose bone
structure is strong and well-defined. Most patients
are in their forties to sixties, but facelifts can
be done successfully on people in their seventies
or eighties as well.
A facelift can make you look younger and fresher,
and it may enhance your self- confidence in the
process. But it can't give you a totally different
look, nor can it restore the health and vitality
of your youth. Before you decide to have surgery,
think carefully about your expectations and discuss
them with your surgeon.
A facelift can improve the deep
cheek folds, jowls and loose, sagging
skin around the neck that come with age.
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All facelift surgery carries
some uncertainty and risk
When a facelift is performed by a qualified plastic
surgeon, complications are infrequent and usually
minor. Still, individuals vary greatly in their
anatomy, their physical reactions, and their healing
abilities, and the outcome is never completely predictable.
Complications that can occur include hematoma
(a collection of blood under the skin that must
be removed by the surgeon), injury to the nerves
that control facial muscles (usually temporary),
infection, and reactions to the anesthesia. Poor
healing of the skin is most likely to affect smokers.
You can reduce your risks by closely following
your surgeon's advice both before and after surgery.
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Planning your facelift plastic
surgery
Facelifts are very individualized procedures.
In your initial consultation the surgeon will evaluate
your face, including the skin and underlying bone,
and discuss your goals for the surgery.
Your surgeon should check for medical conditions
that could cause problems during or after surgery,
such as uncontrolled high blood pressure, blood
clotting problems, or the tendency to form excessive
scars. Be sure to tell your surgeon if you smoke
or are taking any drugs or medications, especially
aspirin or other drugs that affect clotting.
If you decide to have a facelift, your surgeon
will explain the techniques and anesthesia he or
she will use, the type of facility where the surgery
will be performed, and the risks and costs involved.
Don't hesitate to ask your doctor any questions
you may have, especially those regarding your expectations
and concerns about the results.
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Preparing
for your facelift plastic surgery
Your surgeon will give you specific instructions
on how to prepare for surgery, including guidelines
on eating and drinking, smoking, and taking or avoiding
certain vitamins and medications. Carefully following
these instructions will help your surgery go more
smoothly. If you smoke, it's especially important
to stop at least a week or two before and after
surgery; smoking inhibits blood flow to the skin,
and can interfere with the healing of your incision
areas.
If your hair is very short, you might want to
let it grow out before surgery, so that it's long
enough to hide the scars while they heal.
Whether your facelift is being done on an outpatient
or inpatient basis, you should arrange for someone
to drive you home after your surgery, and to help
you out for a day or two if needed.
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Where your facelift surgery
will be performed
A facelift may be performed in a surgeon's office-based
facility, an outpatient surgery center, or a hospital.
It's usually done on an outpatient basis, but some
surgeons may hospitalize patients for a day when
using general anesthesia. Certain conditions such
as diabetes or high blood pressure should be monitored
after surgery, and may also require a short inpatient
stay.
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Types of anesthesia for
facelifts
Most facelifts are performed under local anesthesia,
combined with a sedative to make you drowsy. You'll
be awake but relaxed, and your face will be insensitive
to pain. (However, you may feel some tugging or
occasional discomfort.)
Some surgeons prefer a general anesthesia. In
that case, you'll sleep through the operation.
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The facelift surgery
A facelift usually takes several hours-or somewhat
longer if you're having more than one procedure
done. For extensive procedures, some surgeons may
schedule two separate sessions.
Every surgeon approaches the procedure in his
or her own way. Some complete one side of the face
at a time, and others move back and forth between
the sides. The exact placement of incisions and
the sequence of events depends on your facial structure
and your surgeon's technique.
Incisions usually begin above the
hairline at the temples, follow the
natural line in front of the ear, curve
behind the earlobe into the crease
behind the ear, and into or along the
lower scalp.
If the neck needs work, a small incision may also
be made under the chin.
Facial, neck tissue and muscle may
be seperated; fat may be trimmed or
suctioned and underlying muscle
may be tightened.
In general, the surgeon separates the skin from
the fat and muscle below. Fat may be trimmed or
suctioned from around the neck and chin to improve
the contour. The surgeon then tightens the underlying
muscle and membrane, pulls the skin back, and removes
the excess. Stitches secure the layers of tissue
and close the incisions; metal clips may be used
on the scalp.
After deep tissues are tightened, the
excess skin is pulled up and back,
trimmed and sutured into place.
Following surgery, a small, thin tube may be temporarily
placed under the skin behind your ear to drain any
blood that might collect there. The surgeon may
also wrap your head loosely in bandages to minimize
bruising and swelling.
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After your facelift surgery
There isn't usually significant discomfort after
surgery; if there is, it can be lessened with the
pain medication prescribed by your surgeon. (Severe
or persistent pain or a sudden swelling of your
face should be reported to your surgeon immediately.)
Some numbness of the skin is quite normal; it will
disappear in a few weeks or months.
Your doctor may tell you to keep your head elevated
and as still as possible for a couple of days after
surgery, to keep the swelling down.
If you've had a drainage tube inserted, it will
be removed one or two days after surgery. Bandages,
when used, are usually removed after one to five
days. Don't be surprised at the pale, bruised, and
puffy face you see. Just keep in mind that in a
few weeks you'll be looking normal.
Most of your stitches will be removed after about
five days. Your scalp may take longer to heal, and
the stitches or metal clips in your hairline could
be left in a few days longer.
Most of the scars will be hidden
within you hair and in the normal
creases of your skin.
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Recovery after facelift
surgery
You should be up and about in a day or two, but
plan on taking it easy for the first week after
surgery. Be especially gentle with your face and
hair, since your skin will be both tender and numb,
and may not respond normally at first.
Your surgeon will give more specific guidelines
for gradually resuming your normal activities. They're
likely to include these suggestions: Avoid strenuous
activity, including sex and heavy housework, for
at least two weeks (walking and mild stretching
are fine); avoid alcohol, steam baths, and saunas
for several months. Above all, get plenty of rest
and allow your body to spend its energy on healing.
At the beginning, your face may look and feel
rather strange. Your features may be distorted from
the swelling, your facial movements may be slightly
stiff and you'll probably be self-conscious about
your scars. Some bruising may persist for two or
three weeks, and you may tire easily. It's not surprising
that some patients are disappointed and depressed
at first.
By the third week, you'll look and feel much better.
Most patients are back at work about ten days to
two weeks after surgery. If you need it, special
camouflage makeup can mask most bruising that remains.
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Your new look after facelift
surgery
The chances are excellent that you'll be happy
with your facelift, especially if you realize that
the results may not be immediately apparent. Even
after the swelling and bruises are gone, your hair
may be thin and your skin may feel dry and rough
for several months. Men may find they have to shave
in new places-behind the neck and ears — where
areas of beard — growing skin have been repositioned.
You'll have some scars from your facelift, but
they're usually hidden by your hair or in the natural
creases of your face and ears. In any case, they'll
fade within time and should be scarcely visible.
After surgery, you'll present a
fresher, more youthful face to the
world.
Having a facelift doesn't stop the clock. Your
face will continue to age with time, and you may
want to repeat the procedure one or more times-perhaps
five or ten years down the line. But in another
sense, the effects of even one facelift are lasting;
years later, you'll continue to look better than
if you'd never had a facelift at all.
© Copyright American Society
of Plastic Surgeons
Facelift
FAQs
Below are links to answers to some of the most
frequently asked questions about facelifts.
What
types of facelifts are available?
The "full face-lift" includes the brow, the entire
face and the neck,
traditionally.
Commonly when only the term "face-lift" is used,
the face and neck are what is being referred to.
There are also neck-only lifts, face-only lifts
and regional facelifts, depending on the patients
particular concern.
What
are the advantages and disadvantages of full/regional/etc.
facelifts?
The trade off is generally the length of the incision
necessary to perform the facelift procedure.
Generally, the more areas of the face that need
improvement, the more of an incision is necessary
to carry it out. However, there are some cases in
which the difference in the size of the incision
does not warrant isolating the surgery to one specific
region.
The incision is delicately placed within the hair
(hair is not shaved) and hidden within natural crevises
and folds so it is as inconspicuous as possible.
Younger patients are usually better candidates for
regional facelifts or short-scar
facelifts.
How long
does a facelift last?
No one can say for sure how long a facelift lasts.
The clock is turned back, but keeps on running.
Ten years later, you will look better than if you
never had facelift plastic surgery. Many patients
never have a second facelift, while others may desire
further plastic surgery seven to 15 years later.
What
will be discussed during my consultation for a facelift?
Dr. Antell will ask you what concerns you most
about your appearance and address that region first
and foremost. He will talk about your options, the
facelift surgery, the risks and potential complications,
your recovery period, how much down time you should
allow yourself, the operating room and the anesthesia.
He will show you in a mirror how much improvement
you can expect from facelift surgery by simulating
the amount of tension with his hands. He believes
that computer imaging gives false expectations as
it does not take into account the texture, thickness
and elasticity of your skin, or of your ability
to heal.
Dr. Antell spends as much time as is necessary
with you to make sure you fully understand all the
aspects of the procedure. Dr. Antell has had cosmetic
surgery himself and speaks from experience as a
patient as well as a doctor.
Can facelift
plastic surgery be done without scars?
The scars from facelift plastic surgery usually
fade and are barely perceptible.
In some patients, especially younger ones, endoscopic
surgery can be used to lift the eyebrows, remove
frown lines, elevate the cheek and jowls, and tighten
the neck. This endoscopic surgery can be done with
tiny scars. However, if there is excessive skin,
it must be removed for the best results through
standard facelift incisions.
Can I
have other plastic surgery procedures of the face
done at the same time as a facelift?
Yes, very often patients have their eyes
or their brow done at the same time.
If the surgery is warranted, the final result is
uniform and balanced and there is only one recovery
period.
Some patients ask that their nose
be touched up, because as we age, the tip of the
nose can start to sag as well.
Other patients find that they have lost volume
in their lips as they've gotten older and request
a fat transfer to bulk up their lips for a more
youthful, pouty appearance.
What
is the Submuscular Aponeurotic System?
The SMAS is a layer beneath the skin which invests
the facial muscles. By tightening the SMAS, the
jowls are lifted, the neck is tightened, the cheeks
are elevated. This "deep" or "2-layer" facelift
is an improvement over earlier skin-only techniques.
How
can I hide things during the time until I return
to normal?
After facelift surgery, your plastic surgeon will
discuss post-operative camouflage techniques with
you prior to your surgery, but be assured that while
almost everyone has some sort of temporary side
effect such as bruising and swelling, there are
makeup techniques that both men and women can use
almost immediately to disguise them.
Generally speaking, makeup techniques can be used
soon after facelift plastic surgery to cover discolorations,
and to hide incision lines after the stitches have
been removed and the incision is completely closed.
Camouflage cosmetics include three basic types of
products: concealers to hide incision lines and
discolorations; contour shadows to disguise swelling;
and color correctors to neutralize color in reddened
skin.
Color correctors disguise yellowish discolorations
or the pinkness that follows chemical
peel and dermabrasion.
Lavender neutralizes or removes yellow, and green
has a similar effect on red. It will take a little
patience and practice to master camouflage techniques,
but most post-op patients feel its well worth the
effort.
Can
I see before and after photos of facelift plastic
surgery patients?
As a courtesy to our patients and for patient-confidentiality
reasons, we do not post before-and-afterphotos of
facelift plastic surgery (or any other cosmetic
procedures) on the web site.
We would be happy to show photos of before and
after facelifts to you in the privacy of our office.
Please call us at 1-212-988-4040 or fill
out our contact form if you are interested in a
consultation for a facelift or any of our cosmetic
surgery procedures.
If you would like to contact New York plastic surgeon
Darrick Antell, or if have any further questions
about facelifts or any of our plastic surgery procedures,
please use our contact
form.
Phone: (212) 988-4040
